In-home support for adults with physical disabilities

Who is this service for?

This service is for adults roughly 18 to 59 who live with a physical disability and need hands-on help with daily activities to live in their own home or apartment. That includes people living with spinal cord injuries, multiple sclerosis, cerebral palsy, muscular dystrophy, spina bifida, ALS, amputations, the effects of a stroke or brain injury at a younger age, and other conditions that limit movement and strength. The age range matters because Pennsylvania's Act 150 program and the OBRA waiver are built for adults 18 to 59, and Community HealthChoices serves adults 21 and older.

Older adults who need help are usually served through Community HealthChoices or the county Area Agency on Aging. This page is about younger adults, whose care has different priorities.

Your care, your way

Good personal assistance follows one principle: you are in charge of your own care. Our caregivers are there to do the physical tasks you cannot do yourself, in the way and at the time you want them done. In practice that means:

• You set the routine. Shower at night instead of morning, a particular order for dressing, the way you like your chair positioned. The care plan records it and the caregiver follows it.
• You direct the work. You know your body, your equipment and your transfers better than anyone. Caregivers ask and listen.
• You keep your privacy. Your apartment, your guests, your relationships and your decisions are your own.
• You can change it. If something is not working, including the caregiver match, tell us and we work with you to change it.

Pennsylvania's home care rules back this up: you have the right to take part in planning your services and to have your individual needs and preferences reasonably accommodated.

Should you use an agency or hire your own worker?

Many Pennsylvania programs let you choose between two ways of receiving personal assistance. In the participant-directed model you become the employer: you recruit, hire, train, schedule and supervise your own attendant, who may be a friend or relative, with a financial management services organization handling payroll. In the agency model, an agency like ours employs the caregivers: we recruit, screen, train and supervise them, handle payroll and taxes, and arrange coverage as best we can when a caregiver is out. You still direct how your care is done day to day.

Some people prefer full control of hiring; others want the hiring and backup to be someone else's job. Some use both. It is your choice, and your service coordinator can explain what each program in your situation allows.

Which programs pay for personal assistance?

• Act 150 is a state-funded program for adults 18 to 59 with a physical impairment expected to last at least 12 months, who need a nursing facility level of care, are capable of directing their own care, including hiring, firing and supervising attendants and managing their own affairs, and have been found financially ineligible for Medicaid. A small income-based co-payment may apply. See our guide to the Act 150 program.
• The OBRA waiver serves adults 18 to 59 with a severe developmental physical disability that began before age 22, with substantial limitations in three or more major life activities. People who turn 60 while enrolled can continue.
• Community HealthChoices serves Medicaid-eligible adults 21 and older who need a nursing facility level of care or also have Medicare. Act 150 participants who later become Medicaid-eligible generally move into CHC.

All three start with a call to the Pennsylvania Independent Enrollment Broker at 1-877-550-4227. It's Your Home Care is an enrolled provider for all three, and you can choose any willing and qualified provider. Our page on home care through Medicaid waiver programs walks through enrollment step by step. Private pay and long-term care insurance are also options.

Can the schedule fit around work or school?

Most personal assistance for younger adults is built around fixed points: getting up and ready before a job in Harrisburg or a class at a community college campus, a mid-day bathroom break, dinner, and getting to bed at a reasonable hour rather than whenever an aide happens to arrive. Split shifts, such as a morning visit and an evening visit, are common. Tell us your fixed points at the consultation. In outer counties such as Huntingdon, Juniata or Carbon, longer or combined visits are easier to staff than several very short ones, and we will say honestly what we can cover.

What is outside non-medical care?

We are a non-medical agency. Our caregivers do not administer medications or perform skilled tasks such as catheter insertion, bowel programs requiring digital stimulation, wound or pressure-injury care, tracheostomy care, ventilator management or injections. When those are part of your care, they come from a home health agency or nurses authorized through your program, and our caregivers work alongside them. We provide Medication Reminders and help with self-administration.

Getting started

Call (717) 695-2704. If you are already enrolled in a program, have your service coordinator's name handy. We will meet you at home, go through your routine in detail, write a care plan you agree with, and work to match a caregiver with the skills and temperament that fit.